Organ Donation and Transplantation in Central America

Central America, as constituted by the Republics of Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, and Panama, is characterized by highly diverse social and economic levels reflected by the Human Development Index, ranging from 0.614% for Nicaragua to 0.765 for Costa Rica, and by the percent of Gross Domestic Product dedicated to Public Health Services (ranging from 1.2% in Guatemala to 6.6 in Costa Rica). This has a direct impact on access to transplantation services for the population and on the advancement of deceased donation programs. It is therefore not surprising that only Costa Rica and Panama (and recently El Salvador) have national transplant organizations as part of, and dependent of, and financed by their Ministries of Health. A trend that correlates the Human Development Index with the total number of kidney transplants per year, particularly in developing countries,1–4 is also found in Central America (Figure 1)...